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The cost-effectiveness of grid laser photocoagulation for the treatment of diabetic macular edema: results of a patient-based cost-utility analysis

Sharma, Sanjay MD, MSc (Epid)*; Brown, Gary C. MD, MBA; Brown, Melissa M. MD, MBA; Hollands, Hussein; Shah, Ganrav K. MD§

Current Opinion in Opthalmology: June 2000 - Volume 11 - Issue 3 - p 175-179
Retina and vitreous disorders

Grid laser therapy has been demonstrated to be of benefit for the treatment of diabetic macular edema. The purpose of the present study was to determine the cost-effectiveness of grid laser therapy for the treatment of diabetic macular edema. The analysis was performed from the perspective of a third-party insurer. Decision analyses and cost-effectiveness analyses were performed by incorporating the data from the Early Treatment Diabetic Retinopathy Study, expected longevity data, and patient-based utilities. Various sensitivity analyses were performed to determine the robustness of the models. Laser treatment conferred an overall improvement in quality-of-life adjusted years of approximately 3 months over the duration of disease for a hypothetical patient. The unadjusted cost per quality-of-life adjusted year (QALY) was US$3,101. Net present value analysis demonstrated that the cost per QALY could increase to $3,655, assuming a 5% discount rate. Overall, grid laser photocoagulation for diabetic macular edema is a very cost-effective treatment based on the results of this cost–utility analysis.

*Unit for Cost-Effective Ocular Health Policy, Kingston, Ontario, Canada; Center for Evidence-Based Healthcare, Philadelphia, Pennsylvania, USA; Department of Community Health and Epidemiology, Queen's University, Kingston, Ontario, Canada; §Assistant Clinical Professor, Washington University, St. Louis, Missouri, USA

Correspondence to Sanjay Sharma MD, MSc, Unit for Cost-Effective Ocular Health Policy, Hotel Dieu Hospital, Brock 2, 166 Brock Street, Kingston, Ontario, K7L 5G2, Canada

© 2000 Lippincott Williams & Wilkins, Inc.